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鼻内镜辅助下嗅神经母细胞瘤切除术

Endoscopic-assisted excision of esthesioneuroblastoma.

作者信息

Prasad Kishore Chandra, Kumar Ashwini, Prasad Sampath Chandra, Jain Disha

机构信息

Department of Otolaryngology-Head & Neck Surgery, Kasturba Medical College & Affiliated Hospitals Mangalore, Karnataka State, India.

出版信息

J Craniofac Surg. 2007 Sep;18(5):1034-8. doi: 10.1097/scs.0b013e318157264c.

Abstract

The purpose of this article is to report a case of esthesioneuroblastoma involving the bilateral paranasal sinuses, which was excised using an endoscopic-assisted transfacial approach. A patient presented with nasal swelling and left-sided nasal obstruction, epistaxis, and diplopia. Examination revealed broadening of the nasal dorsum with a fleshy pink mass in both nasal cavities. Computed tomographic scan showed a mass involving the nasal cavity and paranasal sinuses on both sides. The tumor was diagnosed as group C esthesioneuroblastoma. The mass was excised by bilateral medial maxillectomy and bilateral frontoethmoidectomy. Using a 0 degrees endoscope, the attachment of the tumor to the cribriform plate was identified and resected using a motordrill. On Waroff staining, Hispathology slides suggested esthesioneuroblastoma. The patient was asymptomatic for 1 year, following which he developed infection of the nasal cavity for which he had no form of treatment. He subsequently developed maggots in the nasal cavity after which he died. An endoscopic resection of the cribriform plate from the nasal cavity without a formal craniofacial resection can be safely performed with oncologic safety.

摘要

本文旨在报告一例累及双侧鼻窦的嗅神经母细胞瘤病例,该病例采用内镜辅助经面部入路进行切除。一名患者出现鼻肿胀、左侧鼻塞、鼻出血和复视。检查发现鼻背变宽,双侧鼻腔有肉质粉红色肿块。计算机断层扫描显示双侧鼻腔和鼻窦有肿块。该肿瘤被诊断为C组嗅神经母细胞瘤。通过双侧上颌骨内侧切除术和双侧额筛窦切除术切除肿块。使用0度内窥镜,确定肿瘤与筛板的附着部位,并使用电动钻进行切除。在沃罗夫染色中,病理切片提示为嗅神经母细胞瘤。患者无症状1年,之后出现鼻腔感染,未接受任何治疗。随后他鼻腔内出现蛆虫,最终死亡。在肿瘤学安全性方面,可以安全地通过鼻腔对筛板进行内镜切除,而无需进行正式的颅面切除术。

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